[Long-term hypertension control in a community--comparison of stroke incidence and hypertension control between participants and nonparticipants in health examinations].

Since 1969, community-based hypertension control program has been conducted for non-company-employed residents aged 40 and over (3,039: 70% of the residents) in Noichi town, Kochi prefecture. The program is composed of annual health examinations, health education and referral of hypertensives to local physicians. Incidence and mortality of stroke have declined along with a decrease in systolic blood pressure levels. However, during the period of 1982-84, stroke incidence was higher for nonparticipants in health examinations than in the participants of the same age group. For an understanding of the state of detection and control of hypertension in nonparticipants aged 40-69 of the 1982-84 health examinations, blood pressure was examined for 312 subjects randomly selected from the 2,062 nonparticipants. Blood pressure levels were significantly higher in nonparticipants than in participants. In addition, the proportion of hypertensives who were aware of their blood pressure levels was lower in nonparticipants than in participants. About 87% of residents aged 40-69 reported that they received blood pressure checkups at least once a year. Persons who were involved in manual labor, sales and services received blood pressure checkups less frequently. Among company employees, the proportion of persons who checked their blood pressures annually was progressively lower with decrease in size of companies. The community hypertension control appears to have contributed to a decline of blood pressure levels and stroke incidence. However, detection and control of hypertension was relatively poor in nonparticipants in health examinations, particularly for employees of small companies.